Provider Demographics
NPI:1740299668
Name:DAMIANI, ALDO LUCIANO (MD)
Entity type:Individual
Prefix:
First Name:ALDO
Middle Name:LUCIANO
Last Name:DAMIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ESSEX CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2901
Mailing Address - Country:US
Mailing Address - Phone:781-744-8000
Mailing Address - Fax:781-744-4711
Practice Address - Street 1:1 ESSEX CENTER DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2901
Practice Address - Country:US
Practice Address - Phone:781-744-8000
Practice Address - Fax:781-744-4711
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234461207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA109256OtherHPHC
MAJ42598OtherBCBS
MA0043844OtherNEIGHBORHOOD HEALTH PLAN
MA1740299668OtherPHCS
MA1740299668OtherANTHEM
MA1740299668OtherFALLON COMMUNITY HEALTH PLAN
MA1740299668OtherAETNA
MA1740299668OtherBOSTON MEDICAL CENTER HEALTH PLAN
MA1087864OtherCIGNA
MA110078580AMedicaid
MA1740299668OtherUNITED HEALTHCARE
NH30207458Medicaid
MA95569201OtherNETWORK HEALTH
MAJ42598OtherBCBS